ornerie: (gir)
[personal profile] ornerie
hmmm

if we get a national health care option, and everyone who doesnt have private insurance gets on it, and then there's a major H1N1 pandemic like they're predicting this fall....

that's gonna suck. cause it will still be a new system, without the financial resources built up to handle a large scale payout so early in the game.

oooo boy.

*toddles off to make sure assets are liquid, bills are paid and job is secure....*

Date: 2009-08-21 11:23 pm (UTC)
From: [identity profile] gwen-the-potter.livejournal.com
I think it's more likely to have a pandemic than a national health care option by fall...

And if it doesn't pass

Date: 2009-08-21 11:59 pm (UTC)
From: [identity profile] sarahshevett.livejournal.com
And everyone who doesn't have health care gets even sicker because...well they don't have health care...

The system as it exists currently is FAR more expensive.

Re: And if it doesn't pass

Date: 2009-08-22 12:29 am (UTC)
From: [identity profile] ornerie.livejournal.com
oh, belive me, I know the current system is messed up.

so messed up in fact that I dont see how they can fix it. and so laced together with so many other facets of our country that I dont see how they can extricate it.

I just wonder if they will ahve thought of the impending epidemic. fortunately its not a super lethal one, so folks wont die (much) but it will still be a major financial hit on a freshy minted system and that doest seem like the most auspicious start....

Date: 2009-08-22 12:51 am (UTC)
From: [identity profile] joycebre.livejournal.com
I'm allergic to flu shots. :-(

Date: 2009-08-22 12:57 am (UTC)
From: [identity profile] ornerie.livejournal.com
and I dont believe in them...

Date: 2009-08-22 01:05 am (UTC)
From: [identity profile] quincydew.livejournal.com
me neither...never had one and neither have my kids. But in general my kids are NOT shielded from germs and don't get sick much. I loathe the current sanitization of everything for everyones health...it just weakens the immune system.

Date: 2009-08-22 01:58 am (UTC)
From: [identity profile] ornerie.livejournal.com
I agree....for some stuff. now, I'm happy I have my polio shot, and my MMR and keep my tetanus up to date. but flu shots? not so much.

Date: 2009-08-25 04:04 pm (UTC)
From: [identity profile] scratchel.livejournal.com
I would love to talk to you about this topic at some point. (flu-shots, that is) Maybe I can steal a moment of your time at Crown.

Date: 2009-08-25 04:48 pm (UTC)
From: [identity profile] ornerie.livejournal.com
sure thing :)

Huh?

Date: 2009-08-22 01:42 am (UTC)
From: [identity profile] learnteach.livejournal.com
Voted by September, if it is (and it won't be) figure a year to implement. Pandemic is world wide, and we're already in it, but this isn't the kill all flu yet. That'll be in a couple years.

Glad I'm not Indian, Chinese, Indonesian, or...many others.

If the flu doesn't kill you in 3 days, you're usually good. So we should be, economically, not that badly affected.

Or am I missing a lot here?

Re: Huh?

Date: 2009-08-22 01:58 am (UTC)
From: [identity profile] ornerie.livejournal.com
oh, I'm not thinking civilization crumbling apocolypse, I'm thinking major health care reform with best of intentions going horribly wrong and dragging my insurance with it so I'll have to pay for my own until they figure it out.

fortunately I'm (mostly) in a position where I can do that, but good planning will help limit impact....

maybe I shouldnt be reading those CDC updates :)

Date: 2009-08-22 04:52 am (UTC)
From: [identity profile] albionwood.livejournal.com
Well, don't worry, the wingnuts appear to have succeeded in derailing the "public option". And even if they haven't, the best-case options being considered called for full rollout by 2012 or so. If it happens at all, it isn't going to be much affected by H1N1.

Date: 2009-08-22 02:42 pm (UTC)
From: [identity profile] ornerie.livejournal.com
actually that is reassuring. see, I'm all FOR some sort of public health option. even a crappy one full of holes will be better than nothng for tons of people. and for herd immunity to work, a large part of the herd has to be healthy and we dont have that now....

If I was in charge, (and I'm not) the health care reform would consist of
1. rquiring insurance, like they do car insurance
2. requiring employers to provide it or at least help (ex: part timers)
3. if you dont have a job, you get signed up on a government plan, and it should be the same plan state employees have.

have no idea how to pay for this :)

I am also fully aware that this plan will likely mean I dont have a job. When government mandates pricing/prescription protocols for drugs (as has happened just last year with Epo) it will lower costs, sure, but it also means a large segment of the population wont hae access. a significant part of our drug sales come from medicare. last time? we had 30% layoffs.

the jury is still out on the incrased death toll. (for those who dont follow such thngs, Epo is a drug that incrases your red blood cell count. patients undergoing chemo get super anemic. this means they're tired and miserable, not to mention needing transfusions which are dangerous, and being more susceptible to infections and other diseases. Last year (give or take) the government decided that the current dosing guidelines were too generous, and stated that for medicare reimbursement, the physician had to prove that their hematocrit was dangerously low, that it had been dangerously low for a while and that they hadnt been dangerously low before.

if insurance wont pay for it, the patients wont get it. that's what "we can set prices to keep them low" means.

I'm all for a national health care plan. but I dont want my government deciding that a drug is too expensive or what is best for me based on cost. that is for my physician and me to decide.

Current system..

Date: 2009-08-22 06:50 pm (UTC)
From: [identity profile] sarahshevett.livejournal.com
"but I don't want my government deciding that a drug is too expensive or what is best for me based on cost."

And of course, this is what the insurance companies are doing now.

Re: Current system..

Date: 2009-08-23 02:27 am (UTC)
From: [identity profile] ornerie.livejournal.com
yes and no....there are still free market pressures that keep things more open. if an insurance company sucks, there is pressure from employees to switch.

what insurance company and the availability of good plans is considered a benefit, and so is a major hiring and retention point with companies. I know for my company I could choose between an HMO (where prices are set) or a regular payer system...

crappy insurance is a reason not to take (or stay) with a job. now, this might be changing as the job market gets more competitive, dunno....

Re: Current system..

Date: 2009-08-24 05:31 am (UTC)
From: [identity profile] albionwood.livejournal.com
"free market pressures" my a$$. Pressure from employees to switch... to what? All insurance companies suck, just in different ways. And with double-digit unemployment (here for a while), how much pressure can employees really exert - enough to overcome the pressure from management and shareholders to minimize costs?

The health insurance market is not free, it is a racket.

Re: Current system..

Date: 2009-08-24 03:36 pm (UTC)
From: [identity profile] ornerie.livejournal.com
huh...its interesting that your experience is so different from mine.... my company did some major changes to our health care after employee pressure (c0vering alternative medicine, preventative care, etc).

I wonder if the difference is california vs washington?

Date: 2009-08-24 05:22 am (UTC)
From: [identity profile] albionwood.livejournal.com
The whole private-insurance model has failed and must be discarded. If it's in society's interest for everybody to have insurance - and I think that's true - then why not simply make it a basic right of citizenship? (As nearly all other developed nations have already done.)

I hate the idea of requiring everybody to purchase insurance. I especially hate the idea of Federal subsidies to assist lower-income people with that requirement - it's a massive subsidy directly to the health-insurance industry! WTF is that about? Socialism for the rich?

You want only your physician and you to decide what's best for you, regardless of cost? Think that through. Cost isn't a factor? The payer doesn't have any say in the decision? Money is no object? Would you say the same if it was your own money, or if it were someone else's?

The fact is that cost has to be controlled, and that means injecting some form of cost/benefit analysis into medical decisions. Right now everybody seems to be pretending that this isn't already happening (insurers make these kinds of decisions routinely, and their interests are not aligned with the patients') and that it will never be necessary. Crazy shit happens when we don't face up to reality.

National basic health insurance, run by a Federal agency, paid mostly by employers (payroll tax basically offsetting the cost of employer-provided health care, with a net savings coming from reduced staff overhead), with private insurers offering supplemental policies for expanded care to those who want and can pay for it. That works in other countries, it would work here. That's what I want.

Basic question that we as a society have to answer: Is health care a right, or a privilege? If the latter, then we should each pay for it according to our means (more or less the way it works now). If the former, then it should be a collective responsibility of society. If we can't answer the question, we can't solve any of the problems.

Date: 2009-08-24 03:41 pm (UTC)
From: [identity profile] ornerie.livejournal.com
I think I see where we're not comminicataing....

requiring someone to HAVE insurance and requiring them to BUY it are too different things.

I think everyone should be required to have it. either through their employer, or through a government plan. it would be the responsiblity of the employer or govt to see that they had it.

there should be no out of pocket for basic stuff. if you want supplimental stuff, then you can pay or buy a supplimental plan (or pick a job that provides it)

again, I am sure this is totally unworkable and have no idea how to pay for it :)

does that clarify my point a bit better?

Date: 2009-08-24 03:50 pm (UTC)
From: [identity profile] ornerie.livejournal.com
on this:
You want only your physician and you to decide what's best for you, regardless of cost? Think that through. Cost isn't a factor? The payer doesn't have any say in the decision? Money is no object? Would you say the same if it was your own money, or if it were someone else's?


actually, yes.

but then I'm probably more informed than your average health care consumer, I'll grant you.

and it IS my money. I pay 100s of dollars a month for my health care right now (some as flex care money, some as the payment I agreed to make to have the insurance plan I picked, some as benefits that my employer pays in instead of more money in my paycheck). when I've maxed out, they stop paying (as happened last year for me). so I think I do a pretty good job of weighing cost benefit ratios, at least for me.

now, is my ability to work worth paying out for, more than someone elses? I guess thats what you mean by cost:benefit ratio?

I am fully aware that for socialized medicine to succeed, thos are exactly the type of decisions that will be made. but that doesnt mean I have to like it...

and I thiank you hit it on the head... there are some basic society choices we need to make, and frankly I dont know that our nation is ready to do that....

Date: 2009-08-22 03:25 pm (UTC)
From: [identity profile] copper-oxide.livejournal.com
Now I may be totally wrong on this but.....I am not convinced the S. flu is going going to be the pandemic here predicted. Even in Mexico it wasn't as bad as it was portrayed. Although it did have the positive outcome of greatly increasing sanitation and the awareness of more sanitary habits (accoring to DIL).
I think one thing that I notice is how much the word "pandemic" can be associated with the word "panic" and how easy it is to merge those words on the unconscious level. And I wonder if some news organizations take advantage of that?

Date: 2009-08-22 04:26 pm (UTC)
From: [identity profile] ornerie.livejournal.com
I get daily updates from the centers for disease control (I'm a geek :)). there is indeed a flu pandemic.......just like there is every year. there's already almost 8000 cases in the US this year (IIRC), and that's slightly less than there usually is, something that you wisely note will not likely be reported :)

I found it very interesting that this public outcry on the pandemic happened about the time major public health funding was being threatened..... so i twouldnt suprise me a bit if it wasnt a combo of news wanting to sell stories, and public health offices trying to justify their exhistance to a jaded misinformed public.

pandemic just means a disease wave thats spread worldwide....but as you point out, Joe Public adds in the bit about LETHAL OMG WE"RE ALL GOING TO DIE!!!!

dont tell anyone, but I'm not sure I'm gonna correct him, if that means public funding manages to maintain a good level I'm ok with that :)

Date: 2009-08-22 04:40 pm (UTC)
From: [identity profile] copper-oxide.livejournal.com
And what you say about the "slightly less" or even about normal is what I have understood as well. Some of my co-workers seem to have taken the worst-case scenario reports to heart.

Speaking of normal, in a bit of a hijack, do you know of a recipe for zucchini bread that is more interesting than the the average? 95% of the zucchini b. I've been given or made myself is nice, but not delicious. I want something that forces the eyelids up.

Date: 2009-08-23 02:28 am (UTC)
From: [identity profile] ornerie.livejournal.com
mmm zucchini bread....
I use NF yogurt in mine...do you have access to The Best Recipe, the cookbook from cooks illustrated? their recipe is really good. I add in a bunch of stuff like toasty pecans, extra spices and sometimes chocolate chips :)

Date: 2009-08-23 02:39 am (UTC)
From: [identity profile] copper-oxide.livejournal.com
thanks. Pecans add fabulousness to everything, so they should give zucchini bread a boost.
I don't have that recipe book :-( so many books, as they say.
I wonder about baking it in a outdoor brick oven????hummmm

Date: 2009-08-23 02:59 am (UTC)
From: [identity profile] ornerie.livejournal.com
I'll try and manage to type it in for you at some point (maybe tomorrow?)... its a good one and fairly low in fat! yay!

Date: 2009-08-22 10:57 pm (UTC)
From: [identity profile] fjorlief.livejournal.com
Yknow, I started to reply to this thread yesterday when it came up, but decided that my responses were just too snarky to put up among folks who are more or less my friends. This is an issue that I feel very strongly about, since I have had no insurance for most of my adult life, despite working from the age of 15 1/2.

What I don't get is why a public option would suck, and why it it is a good idea to have insurance tied to ones job - I'm self employed, work four different jobs, and noway nohow can afford insurance, it would cost more than my monthly income. I have never been eligible for public assistance of any kind, not even food stamps.

When I am sick, I don't go to the doctor, I keep going to work, and riding on public transit, and shopping at the grocery store, since self-employed means no sick days. I try not to get sick. The USA is full of folks like me, working hard to get by, but without the options the majority take for granted.

According to the June Gallup index, 16% of their respondents had no insurance. Among those making under 36K/year 28.6%. The estimate for artists is about 40%.

and making insurance Mandatory...pray tell how will that help?! I know that car insurance is mandatory, and when it got too expensive, along with the cost of gas and oil, I pulled my old car off the road a year and a half ago and haven't driven it since.

What percentage of net income, (not gross income) do you think is suitable to pay for insurance?

I have no objection to paying my way, but losing my home, or shutting off the utilities, in order to meet a mandated insurance payment is an idea that scares me. There is damn little that I have left to cut from my budget these days, going to SCA events is one of the luxuries that I have pretty much given up these last few years, my only remaining "luxury" is my $30/mo internet access.

Date: 2009-08-22 11:28 pm (UTC)
From: [identity profile] copper-oxide.livejournal.com
Fjorlief, I hear this a lot from my friends who are full time artists/craftspeople. They are, like you, hard workers who pay their bills. But are always in fear of injuries or the illness that would cause them to loose everything or go untreated.

Date: 2009-08-23 02:39 am (UTC)
From: [identity profile] ornerie.livejournal.com
fjorleaf, please know that I am always delighted to have a reasoned discussion. even friends dont have to always agree on everything :)

I think you may misunderstand me. I think insurance should be required, AND I think that if you dont get it from an employer/ job, you should be able to get it from the government same as you get fire and police coverage.

the reason I think it should be required is severalfold:
1. that for insurance to function it MUST include a large pool to normalize risk. if you skew the population for an insurance gorup to only be those who dont have jobs, etc you will be skewing it heavily to those who cant work. I think you'd agree that most people who dont have insurance would be higher risk? (self employed artists etc being the minority there?) by lumping the state employees (lower risk group) with the unemployable (higher risk group) you average the risk overall. the only way for an insurance pool to work is to average the risk. if you fill the pool with high risk folks? it will not be sustainable.

2. herd immunity is an important factor in public health. if the majority of a population is not at risk for a disease, the rest are protected as well as the disease cannot spread. obviously this doesnt work for non contagious things, but it worked for polio...

3. there is too much haves vs have nots in our society (yes, I'm a bit pink tinged on the corners). basic health care is too important to leave to the whims of employers or life circumstances. it should not be a priviledge, it should be a basic human right. not just because it encourages a healthier population (thereby decreasing the chances of ME getting sick), not just because it makes financial sense (see item #1) but because its the right, moral and human thing to do.

does that help explain my position a bit better?

Date: 2009-08-23 06:13 am (UTC)
From: [identity profile] fjorlief.livejournal.com
That does make your statements/sentiments more clear.

I particularly notice that the herd immunity is definitely true - I get sick more often since I started riding the bus, and my friends who either work with young children or have some themselves, get sick more often than anyone else I know.

I understand about how insurance risk pools work, at least as well as any layperson can. Which is why I was really hoping for an everyone-in-the-pool kind of plan, which would spread the risks and the costs across "all of us", as opposed to the kind of patchwork solution that inertia and greed are likely to end us up with (sigh)

For some of the time when I lived in Washington I had Basic Health. It was an affordable option with a sliding scale that was actually realistic. It was a lot better than no insurance, but it certainly did not cover many things that would normally be considered part of medical insurance. (It did cover the surgery on my right hand, but there was no possibility for physical therapy aftercare, for example) The co-pay was high enough that visits to see a doctor were only in cases of definite "need to see, can't fix this at home..." and you never knew what doctor or nurse you would be seeing, but when I had pneumonia, or the time I had campylobactyr from eating Safeway take-out food, it was a good thing to be able to get medical attention.

I wonder why the USA is the ONLY first world country that does not have a national health care option for its people? In all places where there is that kind of option, it is also possible to buy additional or special treatment, if one has the money, but no one goes without care. (Personally, I blame the Protestant Reformation: the idea that those who are right with God will prosper and those who are not prosperous are somehow sinful, and deserve the consequences...but that is another topic entirely)

And I am really curious - what percentage of a persons income do folks think it appropriate to pay for health care (insurance +copay +whatever additional fees)?

Date: 2009-08-23 06:30 pm (UTC)
From: [identity profile] ornerie.livejournal.com
I firmly believe that children are plague carriers and your experience seems to agree :)

re: the protestant reformation "god loves me so I have health insurance"....this is almost a direct quote from my boss. I kid you not. I was dumbstruck and quickly changed the subject. *sigh*. there are some things we Do Not Speak Of (tm)......

what percentage of a persons income is appropriate to pay for health care? I think anyone should be able to go to the ER or a primary health care professional and get basic needs taken care of and not have to pay anything out of pocket. I am fully aware that this means a significant increase in taxes. I am ok with that. remember what I said about it being the right, moral and human thing to do? not to mention herd immunity ;) so its not totally altruisitic on my part, believe me ;)

In my magical fairy land, not only would ERs and primary care providers (oo! and basic dental, too, please!) be "free" (ie paid for by the government, so really by taxpayers) but employers would continue to vie for employees retention by creating competitive additional insurance packages, covering things like extended PT, alternative medicine, smoking cessation, upgraded medical devices, etc.

there are probably a million reasons this wont work. but hey, its MY magical fairy land, so there :)

Date: 2009-08-24 06:54 am (UTC)
From: [identity profile] fjorlief.livejournal.com
Your boss said that!!?! I guess it is not just my imagination that "the Elect" see it that way...

I'd happily pay more taxes if I could go to the doctor. (and as a self-employed, I'm already paying both the employee and employer tax share for myself)

I've never understood why most health insurance covers aliments and injuries, and often a modest amount of preventative care like "check-ups", but doesn't cover dental work, or opthamology, or podiatry. Last time I checked, my teeth, and my eyes, and my feet were all part of my body...

Date: 2009-08-24 03:38 pm (UTC)
From: [identity profile] ornerie.livejournal.com
so whats the different in paying more taxes vs paying a deductible, etc?

I guess i"m confused? its a given number of dollars a month either way?
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